CORPORATE ACCOUNT APPLICATION FORM With this form you can apply for a corporate payment account (with optional internet banking), a saving account and/or time deposit. For each type of account you can select the currency: EUR, USD and/ or RMB. Contact us for more product information, or visit our website www.icbc.co.nl. Note: Corporate account holders cannot apply for a debit card Please complete the application form in BLOCK LETTERS and tick a mark where applicable. Questions with* are optional. Also provide us a complete and duly signed Self-certification form to establish foreign (tax) status. Please keep the environment in mind and print the application form(s) 2 sided. 1 Products Please select the products you wish to apply for Current account RMB EURO USD Saving account RMB EURO USD Time deposit RMB EURO USD Internet banking Please fill in the application form for Internet Banking 2 Company details Statutory Name of the Registered Corporate Customer Trade name Legal form Industry Description of Business Activities Please provide detailed information of the nature of your products and/or services Geographic location of the business Please provide detailed information of the area(s) of your business activities. Corporate Tax Identification Number, (Dutch Companies: RSIN number). Chamber of Commerce number (KVK number/number of Business License) Registered city of Chamber of Commerce Business registration date Purpose of account/intended use Deposit Saving / Time deposit Overseas payments, mainly to Domestic payments Other, (geographic areas) 1 / 8
3 Contact details 3.1 Registered Office Address Street name and number Telephone number *FAX *Email Note: If office address and/or postal address are not the registered office address, please fill in 3.2 and/or 3.3 * 3.2 Office Address and country Street name and number * 3.3 Postal address and country *Recipient Street name and number 3.4 Bank statement Send the bank statement to: Email: Registered address Office address Postal address 4. Authorized Representative(s) Note: In case of more than 2 authorized representatives, please fill in the additional form in attachment 1 4.1 Personal details Representative 1 Representative 2 Gender Surname Prefix * Given names Date of Birth Place of Birth of birth Marital status* Profession/ Position in the company Male Female Male Female 4.2 Identification details Identification type Identification number Nationality BSN number/tax number Issue date Identification card Passport Residence Certificate Others: Identification card Passport Residence Certificate Others: 2 / 8
Expiry date Issuing city or country 4.3 Contact details Resident Street name and number Telephone number (work) Telephone number (home) Mobile Number* FAX* Email* 5. Signature The Customer acknowledges having read the (i) General Banking Conditions issued by the Dutch Banking Association (ii) Explanatory Notes to these General Banking Conditions (iii) Terms and Conditions Retail Customers applicable to the account (s) and related banking services and hereby confirms having understood its terms and conditions and his acceptance to be bound by it. Full name Position Signing authority Authorized representative 1 Authorized representative 2 Individual Joint with Individual Joint with Restrictions on Signature If yes, please specify Place and date Authorized signature 3 / 8
6. Identification form for ultimate beneficial owners The Dutch Anti-Money Laundering and Anti-Terrorist Financing Act (Wwft), requires banks to fulfill a number of client identification duties. One of these duties is to identify the Ultimate Beneficial Owners (UBO s) of their customers. Within the meaning of the law, Ultimate Beneficial Owners of a legal entity are natural persons who hold or control a participation of at least 25% in the capital or at least 25 % of the voting rights of a company or who undertake de jure or de facto management of the legal entity. For more information, please refer to the explanatory notes in the annex. The undersigned (1), Surname and given names Function (2) Signature A. B. C. D. acting as legal representative(s) for Name of the customer City and country of registered office Company number certifie(s), in accordance with article 1 section a under f of the Wwft, that on beneficial owners of the customer are the following natural persons (3): (current date), the ultimate declares there is (are) no shareholder(s) who hold(s) > 25% of the shares, but the \natural person(s) in control are the following table below. declares there is (are) shareholder(s) who hold(s) > 25% of the shares. They are the natural persons in the following table below. 4 / 8
Surname and given names Registered address, number, city country if applicable Function(4) %of the shares (direct or indirect) and/or that the ultimate beneficial owner is the following listed company: Company name Address of registered office Stock exchange on which listed OR the company is owned by the following government institution: Name institution Address of registered office and irrevocably undertake(s) to inform the bank immediately, in writing, of any modification to the list of Ultimate Beneficial Owners (both shareholders and decision makers) of this legal entity and provide a copy of the identity documents of the new Ultimate Beneficial Owners. (1) If the ICBC Europe (S.A.) Amsterdam Branch does not yet have such documentation in it s possession, attach a copy of proof of identity (passport or ID card) (2) Fill out the correct job title of the persons authorized to represent the legal entity (e.g., director, chairman, managing director) (3) If the ICBC Europe (S.A.) Amsterdam Branch does not yet have such documentation in it s possession, attach a copy of proof of identity (passport or ID card) (4) Fill out the capacity of the beneficial owner (e.g. shareholder, director) ANNEX accompanying the Ultimate Beneficial Owner declaration 1. Why do banks have to ask for an Ultimate Beneficial Owner declaration? The law on the prevention of the use of the financial system for the purpose of money laundering and terrorist financing requires financial institutions to identify the Ultimate Beneficial Owners of their clients. The Ultimate Beneficial Owner(s) is or are the natural person(s) for the account or the benefit of whom a transaction is executed or a commercial relation is established or who has(ve) the ultimate control over the client. Ultimate Beneficial Owners of legal persons, trusts and other unincorporated legal structures are therefore the natural persons who ultimately own or control the customer. In order to comply with this legal obligation to identify and report the Ultimate Beneficial Owner of a legal person, an Ultimate Beneficial Owner declaration should be completed by the representatives of the customer-company or entity. 5 / 8
2. Who should complete and sign the declaration? The declaration must be completed by the persons authorized to represent the company or entity according to its Articles of Association unless other persons have a power of attorney to do so. 3. Why are Ultimate Beneficial Owners important? Ultimate Beneficial Owners of a legal entity are deemed to be important as they are considered to be in control of the legal entity. Being in control is in this case defined as being able to decisively influence the appointment of the majority of the board members / senior executives or to decisively influence the orientation of the company. 4. Ultimate Beneficial Owners: sometimes referred to as owners, sometimes as decision makers The term Ultimate Beneficial Owners is commonly interpreted as meaning owners or holders. This interpretation is correct but not complete. All natural persons who own or control 25% or more of the capital or 25% or more of the voting rights are considered Ultimate Beneficial Owners. Next to these controlling shareholders also other natural persons are considered to be Ultimate Beneficial Owners. These persons are referred to as the beneficial decision makers of any kind but who are de facto exercising similar control over the company. Having control is defined as being able to decisively influence the appointment of the majority of the board members / senior executives or to decisively influence the orientation of the company. These persons are considered to be beneficial decision makers as well. 5. What if a legal entity is shareholder in your company? In general Ultimate Beneficial Owners must be named natural persons. If the owners of a legal entity are themselves one or more companies, then further information is required to establish the identity of the natural persons who are the owners of these companies. These natural persons are to be filled in directly as the Ultimate Beneficial Owner(s) on the declaration of the company/association regardless of the number of intermediate steps. In order to be clear about the intermediate steps the controlling shareholders of the underlying legal entities need to be identified. For example, in case company A is >25% owned by company B all controlling shareholders of company B are to be listed as UBO s of company A. In more complicated cases whereby company B is 25% owned by company C the controlling shareholders of company C are to be listed as UBO s of company A. In the form you are requested to mention the percentage of shares. For indirect ownership it is not needed to calculate the percentage of the percentage. It is sufficient to mention the notion indirect in this field. In some specific limited cases that are listed below the Ultimate Beneficial Owner can be another legal person. 6. Who is to be named as UBO? The following list indicates who should be considered being an Ultimate Beneficial Owner for the various types of entity. A. Companies (except non-profit organizations) A.1 The company is not listed on a stock exchange and there is a limited number of larger shareholders or owners controlling the company. Owning or controlling 25% (or more) of the shares or voting rights is considered a controlling share. Exercising at least 25% of the voting rights at the general meeting of the company is also considered a controlling share. Ownership may be direct or indirect (for example, via intermediary companies) or a combination of both. In this case, the shareholders or owners must be named on the declaration. A.2 The company is not listed on a stock exchange and there are a large number of smaller shareholders or owners. (All the situations not falling within the definition at A.1, fall within A.2) In this situation, it is difficult or impossible in practice to provide the names of all the owners. A statement needs to be made of the fact that no individual shareholder with a holding of 25% or more exists. A.3 The company is not listed on a stock exchange, but is owned by another company that is listed on a stock exchange. A declaration needs to be drawn up identifying the owning listed company + the stock exchange on which the owning company is listed. A.4 The company is partly listed on a stock exchange. For companies that are partly stock-listed and partly privately held the Ultimate Beneficial Owners of the privately held part still need to be identified as in A1 or A2. 6 / 8
A5. The company is listed on a stock exchange. The stock exchange on which the company is listed needs to be identified. A statements needs to be made of the fact that no individual shareholder with a holding of >25%or more exists. B. Non-profit organizations. No one owns a non-profit organization. In such cases, the declaration must contain the names of the persons exercising actual control or making executive decisions, i.e.: the decision makers of the non-profit organization. See explanation in 4. above. C. Foundations, Trusts, Fiduciaries, etc No one owns a foundation, trust or fiduciary. In these cases the UBO is: A natural person who, directly or indirectly, exercises control of over 25% of the property of the trust or foundation i.e.: the decision makers. See explanation in 4. above. Any natural person who is, directly or indirectly, a beneficiary of more than 25% of the property in the trust or foundation. These are the persons expressly named as beneficiaries in the trust deed, or the persons who may be considered the beneficiaries. In case of a trust please provide the ICBC of a Trust deed, on which the names and addresses of the settlor, trustees and the beneficiaries are stated by the trustee. 7. What documents to attach? In addition to completing this declaration, the company or entity must for each person indicated/named in the declaration as Ultimate Beneficial Owners provide photocopies of the identity card (for European citizens) or the international passport. 7 / 8
Attachment 1: Additional form for Authorized Representative(s) Note: Please fill this form if there are more than 2 authorize representatives Personal details Gender (M/F) Surname Prefix* Given names Date of Birth Place of Birth of birth *Marital status Profession Position in the company Identification details Identification type Identification number Nationality *BSN/tax number Issue date Expiry date Issuing city or country Contact details Street name and number Representative (1) Representative (2) Male Male Female Female Identification card Passport Residence Certificate Others: Identification card Passport Residence Certificate Others: Telephone number (work) Telephone number (home) Mobile Number FAX* Email* Signatures of the authorized representative(s) Representative (1) Representative (2) Name Position Place Date (DD/MM/YY) Signature 8 / 8